L15+16: HTN

Question 1

Atenolol

Answer 1

B1 selective blocker

Question 2

Do B blockers vasodilate?

Answer 2

NO

Question 3

What are the HIP drugs?

Answer 3

Hydralazine
Isoniazid
Procainamide

All are capable of inducing SLE in slow acetylators

Question 4

Do not affect plasma lipids

Answer 4

Prazosin and other a1 adrenergic antagonists

Question 5

hemolytic anemia with a (+) Coombs test

Answer 5

Methyldopa

Question 6

Most HTN is

Answer 6

primary/essential

Question 7

Nebivolol

Answer 7

B1 selective blocker

Question 8

HTN leads to

Answer 8

an increased incidence of renal failure, CAD, HF, and stroke

That’s why we treat it

Question 9

Which vasodilators are IV for emergencies only?

Answer 9

Nitroprusside
Fenoldopam
CCBs (some)

Question 10

Timolol

Answer 10

non selective B blocker

Question 11

Metoprolol

Answer 11

B1 selective blocker

Question 12

First dose phenomenon

Answer 12

Prazosin and other a1 adrenergic antagonists

Question 13

HTN+BPH

Answer 13

Prazosin and other a1 adrenergic antagonists

Question 14

B blockers are the preferred treatment for

Answer 14

Angina
Post-MI
Migraine

Question 15

Acebutolol

Answer 15

B1 selective blocker

Question 16

Treat stage 1 htn with

Answer 16

1 drug

Question 17

HTN tx failure is usually due to

Answer 17

non-compliance

Question 18

BP >140 or DBP >90

Answer 18

stage 2 htn

Question 19

Diltiazem and verapamil produce

Answer 19

bradycardia

vs nifedepine reflex tachy

Question 20

Main adverse effects of central acting sympatholytics (clonidine and Methyldopa)

Answer 20

Sedation and other CNS effects

Xerostomia

ED

Question 21

Propranolol

Answer 21

non selective B blocker

Question 22

BP 130-139 or DBP 80-89

Answer 22

Stage 1 htn

Question 23

How to counteract first dose phenomenon with a1 antagonists (prazosin)

Answer 23

Give doses at night

Question 24

Adverse effects of alpha 1 antagonists

Answer 24

“First dose phenomenon” - postural hypotension may be pronounced with the first dose

Reflex tachycardia

Question 25

Which is the only ß-blocker that IS a vasodilator?

Answer 25

Nebivolol by NO

Question 26

Which vasodilators can be used long term (oral)?

Answer 26

Hydralazine
Minoxidil
CCBs

Question 27

CCBs effects

Answer 27

Decreased contractility —> NEGATIVE INOTROPIC

Decreased impulse generation in the SA node —> NEGATIVE CHRONOTROPIC

Decreased AV node conduction —> NEGATIVE DROMOTROPIC

Question 28

Fenoldopam (post-synaptic D1 agonist) is used for

Answer 28

For emergency hypertensive situations

IV only with short half-life

Question 29

Nadolol

Answer 29

Non selective B blocker

Question 30

HTN drug for pregnancy

Answer 30

methyldopa

Question 31

Treat stage 2 htn with

Answer 31

2 drugs

Question 32

How do thiazide diuretics have a vasodilating effect?

Answer 32

Long term effects (6-8 weeks):

decrease Na+ in muscle cells, activate K+ channels which decreases sensitivity to vasopressors
→ decreased peripheral resistance→ BP lowered 10-15 mmHg

Question 33

ACE-Is are good for

Answer 33

reducing afterload and preload

Question 34

Which CCB is most likely to produce reflex tachycardia

Answer 34

Nifedipine (highest vasodilation —> marked hypotension —> reflex tachycardia)

Question 35

What’s the biggest benefit of Central Acting Sympatholytics (Clonidine, Methyldopa) in treatment of HTN?

Answer 35

No reflex tachycardia

They stimulate medullary a2 adrenergic receptors —> reduced peripheral sympathetic nerve activity

Question 36

Why do thiazide diuretics decrease insulin secretion?

Answer 36

Cause K+ channel opening